浮风虚暑滑多痰，实壅弦劳迟主寒，洪数热多芤失血，涩为血少缓肤顽，紧疼沉里濡多汗，
促结伏皆痰郁看，短是气虚长是积，动惊牢弱骨疼酸，革崩半产细伤湿，散为气耗代将亡。
察脉之要，莫急于人迎寸口，是二脉相应如两引绳，阴阳均则绳之大小等。凡平人之脉，人
迎大于春夏，寸口大于秋冬。何谓人迎？喉傍取之，《内经》所谓别于阳者也。越人不尽取诸穴
之脉，但取手太阴之行度，鱼际后一寸九分，以配阴阳之数，而得关格之脉。然不先求喉手引绳
之义，则昧尺寸阴阳关格之所起。寸口倍于尺则上鱼而为溢，故言溢者寸倍尺极矣。溢之脉，一
名外关，一名内格，一名阴乘之脉。曰外关者，自关以上外脉也，阴拒阳而出，故曰外格，阴生
于阳寸动于尺，今自关以上溢于鱼际，而关以后脉伏行，是为阴壮乘阳而阳竭，阳竭则死，脉有
是者死矣。此所谓寸口四倍于人迎，为关阴之脉者也。关以后脉当一寸而沉，过
者谓尺中倍寸口至，三倍则入寸而为覆，故言寸者，尺倍寸极矣。覆之脉，一名内关，一名外格，
一名阳乘之脉。内关者，关以下内脉也。外格者，阳拒阴而内入也。阳生于阴尺动于寸，今自关
以下覆入尺泽，而关以下脉伏行，则为阳亢乘阴，而阴竭亦死，脉有是者死矣。此所谓人迎四倍
于寸口，为格阳之脉也。经曰∶人迎与寸口皆盛，过四倍则为关格。关格之脉羸，不能极天地之
精气而死。所谓关格者，覆溢是也。虽然，独覆独溢，则补泻以生之。尺部一盛，泻足少阳补足
厥阴，二盛，泻足太阴补足少阴，三盛，泻足阳明补足太阴，皆二泻而一补之。四盛则三极，导
之以针，当尽取少阳太阴阳明之穴。脉弱者取三阳于足，脉数者取于手少阳二，当补于阴一。至
寸而反之。脉有九候者，寓浮沉于寸关尺也。且越人不取十二经者，穴直以二经配合于手太阴行
度自尺至寸，九分之位复分三部，部中有浮中沉以配天地人也。又曰∶中风木伤寒金湿水热火温，
病起于湿，湿则土病，土病而诸脏受害，其本生于金木水火四脏之变也。阳浮阴微为风湿，阳数
阴实为温毒，阳濡阴急为湿温，阴阳俱盛为温疟。其治也，风湿取足厥阴木、手少阳火，温毒专
取少阴火，伤寒取手太阴金木、手少阴火，湿温取足少阴水。乡人皆为我能与伤寒语，我察伤寒与
四温变，辨其疑似而不可乱也。故定阴阳于喉手，配覆溢于寸尺，寓九候于浮沉，分四温于伤寒。
此皆扁鹊略闻其端，而余参以《内经》诸书，可究而得其说，审而用之，顺而治之，病不得逃焉。
（张佑史方）
浮脉主风、虚证、暑邪；滑脉主痰湿多盛；实脉主气机壅滞；弦脉主劳损；迟脉主寒证。洪数脉主热邪亢盛；芤脉主失血；涩脉主血少；缓脉主皮肤顽麻。紧脉主疼痛；沉脉主里证；濡脉主多汗。促脉、结脉、伏脉皆因痰浊郁滞所致。短脉主气虚；长脉主积滞。动脉主惊悸；牢脉、弱脉主骨节疼痛酸软。革脉主崩漏或半产（小产）；细脉主伤湿；散脉主气耗散；代脉主元气将亡。
诊察脉象的关键，没有比观察人迎穴和寸口穴更急迫的了。这两处脉象相应，就像两根并引的绳子一样，阴阳平衡时，绳子的粗细就相等。凡是健康人的脉象，人迎脉在春夏季节略大，寸口脉在秋冬季节略大。什么叫人迎脉？是在喉咙旁边取脉，《内经》称之为“别于阳”的方法。扁鹊（越人）并不完全取用所有穴位的脉象，只取手太阴肺经的行度，在鱼际穴后一寸九分的位置，以此来配合阴阳的数理，从而得出关格之脉的道理。然而，如果不先探求喉部与人迎、手部与寸口之间如两绳牵引的意义，就会不明白尺寸、阴阳、关格产生的根源。如果寸口脉比尺脉大一倍，就会向上延伸至鱼际而成为“溢”脉，所以说“溢”，是指寸脉比尺脉大一倍的极端情况。溢脉，又名叫外关，又叫内格，又叫阴乘之脉。称为外关，是因为它是从关位以上向外延伸的脉，阴气拒绝阳气而出，所以叫外格。阴本生于阳，寸动于尺，现在从关位以上溢出到鱼际，而关位以后的脉伏行不见，这是阴气壮盛乘袭阳气而导致阳气枯竭，阳气枯竭就会死亡，脉象出现这种情况的就会死。这就是所说的寸口脉四倍于人迎脉，是关阴之脉。关位以后的脉应当在一寸处下沉，如果超过这个限度，就说尺中脉比寸口脉大一倍到达此处，大三倍则进入寸部而成为“覆”脉，所以说“覆”，是指尺脉比寸脉大一倍的极端情况。覆脉，又名叫内关，又叫外格，又叫阳乘之脉。内关，是指关位以下向内延伸的脉。外格，是指阳气拒绝阴气而向内入。阳本生于阴，尺动于寸，现在从关位以下覆盖进入尺泽，而关位以下的脉伏行不见，这是阳气亢盛乘袭阴气而导致阴气枯竭，阴气枯竭也会死亡，脉象出现这种情况的就会死。这就是所说的人迎脉四倍于寸口脉，是格阳之脉。经文说：人迎与寸口脉都盛大，超过四倍就是关格。关格的脉象身体消瘦羸弱，不能穷尽天地的精气而死。所谓关格，就是指覆脉和溢脉。虽然如此，如果是单独的覆脉或单独的溢脉，就可以通过补泻的方法来救治。尺部脉大一倍，泻足少阳胆经，补足厥阴肝经；大二倍，泻足太阴脾经，补足少阴肾经；大三倍，泻足阳明胃经，补足太阴脾经，都是采用二泻一补的方法。大四倍则三极（指病情危重极限），需要用针导引，应当全面取用少阳、太阴、阳明的穴位。脉弱的取足部三阳经的穴位，脉数的取手部少阳经二穴，应当补阴经一穴，直到寸部再反过来操作。脉有九候，是将浮沉寓于寸关尺之中。而且扁鹊不取十二经的脉，而是直接以两条经脉配合在手太阴肺经的行度上，自尺至寸，九分的位置又分为三部，每部中有浮、中、沉三种脉象来配合天、地、人。又说：中风属木，伤寒属金，湿病属水，热病属火，温病属温。疾病起于湿，湿则导致脾土病变，脾土病变而其他脏腑受害，其根本来源于金、木、水、火四脏的变化。阳浮阴微为风湿，阳数阴实为温毒，阳濡阴急为湿温，阴阳俱盛为温疟。治疗方面，风湿取足厥阴肝经木穴、手少阳三焦经火穴；温毒专取少阴心经火穴；伤寒取手太阴肺经金木穴、手少阴心经火穴；湿温取足少阴肾经水穴。乡人都认为我能与伤寒对话，我考察伤寒与四种温病的变化，辨别它们的疑似之处而不混乱。所以定阴阳于喉部与人迎、手部与寸口，配覆溢于寸部与尺部，寓九候于浮沉，分四温于伤寒。这些都是扁鹊略微听说其端倪，而我参考《内经》等书籍，可以探究并获得其中的道理，审慎地使用它，顺应它来治疗疾病，疾病就无法逃脱了。（张佑史方）
A floating pulse indicates wind, deficiency, or summerheat; a slippery pulse indicates excessive phlegm-dampness; a full pulse indicates qi stagnation and obstruction; a wiry pulse indicates labor injury (chronic strain); a slow pulse indicates cold. A surging or rapid pulse indicates excessive heat; a knotted pulse indicates blood loss; a choppy pulse indicates blood deficiency; a moderate pulse indicates numbness and hardness of the skin. A tight pulse indicates pain; a deep pulse indicates interior syndromes; a soggy pulse indicates profuse sweating. A hurried, knotted, or hidden pulse are all viewed as caused by phlegm-turbidity stagnation. A short pulse indicates qi deficiency; a long pulse indicates accumulation. A moving pulse indicates fright; a firm or weak pulse indicates bone pain and soreness. A leathery pulse indicates metrorrhagia or miscarriage; a fine pulse indicates damage from dampness; a scattered pulse indicates qi consumption; a intermittent pulse indicates impending collapse of yuan-qi.
The key to observing pulses lies most urgently in examining the Renying (Human Welcome) point and the Cunkou (Inch Port) point. These two pulses correspond to each other like two ropes pulled together; when yin and yang are balanced, the thickness of the ropes is equal. In healthy individuals, the Renying pulse is larger in spring and summer, while the Cunkou pulse is larger in autumn and winter. What is the Renying pulse? It is taken beside the throat, referred to in the *Neijing* (Inner Canon) as "distinguishing yang." Bian Que (Yue Ren) did not fully utilize pulses from all acupoints but only took the course of the Hand-Taiyin Lung Meridian, at one cun and nine fen behind the Yuji point (LU10), to coordinate with the numbers of yin and yang, thereby deriving the concept of Guan-Ge (Blockage and Rejection) pulses. However, without first seeking the meaning of the Renying-Cunkou relationship resembling two drawn ropes, one would be ignorant of the origins of Cun-Chi (Inch-Ruler), yin-yang, and Guan-Ge. If the Cunkou pulse is double that of the Chi pulse, it extends upward to the fish margin, becoming an "Yi" (Overflowing) pulse. Thus, "Yi" refers to the extreme case where the Cun pulse is double the Chi pulse. The Yi pulse is also called Wai-Guan (External Blockage), Nei-Ge (Internal Rejection), or Yin-Cheng (Yin Overcoming) pulse. Called Wai-Guan because it is the pulse extending outward above the Guan position, where yin rejects yang and exits, hence named Wai-Ge. Yin originates from yang, and movement occurs in Chi relative to Cun. Now, overflowing above the Guan to the fish margin, while the pulse below the Guan runs hidden, this indicates vigorous yin overcoming yang, leading to the exhaustion of yang. When yang is exhausted, death ensues; those with such pulses die. This is what is meant by the Cunkou pulse being four times that of the Renying, known as the Guan-Yin pulse. Below the Guan position, the pulse should sink at one cun. If it exceeds this, it is said that the Chi pulse reaches double the Cunkou pulse; if triple, it enters the Cun position, becoming a "Fu" (Overturning) pulse. Thus, "Fu" refers to the extreme case where the Chi pulse is double the Cun pulse. The Fu pulse is also called Nei-Guan (Internal Blockage), Wai-Ge (External Rejection), or Yang-Cheng (Yang Overcoming) pulse. Nei-Guan refers to the pulse extending inward below the Guan position. Wai-Ge refers to yang rejecting yin and entering inward. Yang originates from yin, and movement occurs in Cun relative to Chi. Now, overturning downward below the Guan into the Chize area, with the pulse below the Guan running hidden, this indicates hyperactive yang overcoming yin, leading to the exhaustion of yin. When yin is exhausted, death ensues; those with such pulses die. This is what is meant by the Renying pulse being four times that of the Cunkou, known as the Ge-Yang pulse. The classics state: When both Renying and Cunkou pulses are vigorous, exceeding four times constitutes Guan-Ge. The Guan-Ge pulse involves emaciation, inability to exhaust the essence and qi of heaven and earth, leading to death. Guan-Ge refers to the Fu and Yi pulses. Nevertheless, if there is only Fu or only Yi, they can be treated with tonification and sedation. If the Chi section is one-fold stronger, sedate Foot-Shaoyang Gallbladder Meridian and tonify Foot-Jueyin Liver Meridian; if two-fold stronger, sedate Foot-Taiyin Spleen Meridian and tonify Foot-Shaoyin Kidney Meridian; if three-fold stronger, sedate Foot-Yangming Stomach Meridian and tonify Foot-Taiyin Spleen Meridian. All these use two sedations for one tonification. If four-fold stronger, it reaches the limit of three extremes; guide with needles, taking points from Shaoyang, Taiyin, and Yangming meridians. For weak pulses, take points from the three Yang meridities on the foot; for rapid pulses, take two points from Hand-Shaoyang Sanjiao Meridian and tonify one yin point, reversing this at the Cun level. Pulse has nine inspections, embedding floating and sinking within Cun, Guan, and Chi. Furthermore, Bian Que did not take twelve meridians' pulses directly but paired two meridians with the Hand-Taiyin course. From Chi to Cun, the nine-fen position is divided into three sections, each having floating, middle, and sinking qualities corresponding to Heaven, Earth, and Man. It is also stated: Wind-stroke belongs to Wood, Cold damage belongs to Metal, Dampness belongs to Water, Heat belongs to Fire, Warmth belongs to Warmth. Diseases originate from dampness; dampness causes Spleen-Earth pathology, which harms other zang-organs. The root lies in changes among Metal, Wood, Water, and Fire organs. Floating yang and faint yin indicate Wind-Damp; rapid yang and solid yin indicate Warm-Toxin; soggy yang and urgent yin indicate Damp-Warmth; vigorous yin and yang indicate Warm-Malaria. Treatment: Wind-Damp takes Foot-Jueyin Wood and Hand-Shaoyang Fire points; Warm-Toxin exclusively takes Shaoyin Fire points; Cold Damage takes Hand-Taiyin Metal/Wood and Hand-Shaoyin Fire points; Damp-Warmth takes Foot-Shaoyin Water points. People say I can converse with Cold Damage; I examine the variations between Cold Damage and the Four Warmths, distinguishing their similarities and differences without confusion. Thus, yin and yang are determined by Renying/Cunkou; Fu/Yi are matched to Cun/Chi; Nine Inspections are embedded in Floating/Sinking; Four Warmths are distinguished from Cold Damage. These were merely glimpsed by Bian Que, but I have consulted the *Neijing* and other texts to investigate and understand them. By examining and applying them, and treating in accordance with principles, diseases cannot escape. (Zhang You Shifang)